For obese people, losing fat mass is a crucial step on the way to better health and life expectancy. However, after the first few pounds have disappeared, the body compensates in various ways to prevent further weight loss – for example, by reducing the metabolic rate and increasing hunger.
As a result, patients tend to plateau in weight loss before reaching their final goal, as diet and exercise programs that initially showed promise prove ineffective after this early phase. One possible strategy to avoid such a premature plateau is to adjust diet and activity plans based on changes in whole-body energy expenditure over time. A new study sought to investigate whether using energy expenditure biofeedback to inform and adjust weight loss strategies would improve loss of body weight and fat mass compared to standard diet and activity counseling alone.
In this randomized trial, 52 participants with obesity were counseled by dietitians and instructed to maintain a standard caloric restriction (30% or 500 kcal/day below daily energy requirements, whichever was greater) and at least 150 minutes of physical activity per week during the 24-week study. For half of these participants (INT group), dietitians modified recommendations throughout the study based on energy expenditure information derived from wearable indirect calorimetry devices, while dietitians did not modify recommendations for control participants. At the end of the study, participants in the INT group had lost more weight overall than the control group (-2.3 kg; 95% CI: -3.1 to -1.5; P<0.001) and had a greater reduction in body fat percentage (-1.5%; 95% CI: -2.31 to -0.72; P<0.001).
In addition, a significantly higher proportion of participants in the INT group achieved a weight loss of at least 5% from baseline than participants in the control group (42% of the INT group versus 8% of the control group; P=0.007). These results suggest that integrating continuous feedback on metabolic changes to personalize and adjust diet and exercise plans may improve the likelihood of avoiding weight plateaus before reaching weight loss goals.
Biofeedback is a relevant aspect of BIOCOACHING that provides accurate information about the status quo and the change in health status through interventions recommended by the BIOCOACH based on the relevant health and lifestyle data.
